Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 1/2016

01-01-2016 | Original Article

Short-term outcomes following reduced-port, single-port, and multi-port laparoscopic surgery for colon cancer: tailored laparoscopic approaches based on tumor size and nodal status

Authors: Hyeon Yu, Jin Yong Shin

Published in: International Journal of Colorectal Disease | Issue 1/2016

Login to get access

Abstract

Purpose

Surgeons have recently developed more minimally invasive surgical procedures to reduce surgical stress and improve cosmesis. Although single-port laparoscopic colectomy (SPLC) has potential benefits over multi-port laparoscopic colectomy (MPLC), there are concerns about the increased technical difficulties associated with SPLC. Therefore, we attempted reduced-port laparoscopic colectomy (RPLC). The purpose of this study was to evaluate the difference in perioperative outcome following tailored laparoscopic approaches for colon cancer on the basis of tumor characteristics.

Methods

The prospectively collected data of 170 patients who underwent only minimally invasive colectomy for colon cancer from July 2010 to June 2013 were reviewed. The MPLC, SPLC, and RPLC groups comprised 92 (54.1 %), 40 (23.5 %), and 38 (22.4 %) patients, respectively.

Results

The number of harvested lymph nodes was significantly higher in the RPLC group than in the MPLC and SPLC groups (29.9 ± 21.5, 21.9 ± 12.1, and 24.2 ± 13.8, respectively; p = 0.027). The mean operating time was significantly different among the MPLC, SPLC, and RPLC groups (243.5 ± 59.0, 207.2 ± 49.6, and 216.2 ± 53.7 min, respectively; p = 0.001). The time to first flatus was also significantly different among the MPLC, SPLC, and RPLC groups (3.1 ± 1.2, 3.6 ± 1.3, and 3.4 ± 1.1 days, respectively; p = 0.039). No significant differences in the other short-term surgical outcomes were observed among the three groups.

Conclusions

SPLC and RPLC according to tailored laparoscopic approaches for colon cancer appear to be beneficial in terms of operative time and lymph node retrieval, and may be considered as surgical options in laparoscopic colectomy for colon cancer patients with favorable tumor characteristics.
Literature
1.
Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1(3):144–150PubMed
2.
Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359(9325):2224–2229PubMedCrossRef
3.
Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, Heath RM, Brown JM, UK MRC CLASICC Trial Group (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25(21):3061–3068PubMedCrossRef
4.
Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350(20):2050–2059CrossRef
5.
Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Nelson H, Clinical Outcomes of Surgical Therapy Study Group (2007) Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg 246(4):655–662PubMedCrossRef
6.
Jayne DG, Thorpe HC, Copeland J, Quirke P, Brown JM, Guillou PJ (2010) Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 97(11):1638–1645PubMedCrossRef
7.
Hasegawa F, Kawamura YJ, Sasaki J, Tsujinaka S, Konishi F (2013) Oncological 3-port laparoscopic colectomy by 1 surgeon and 1 camera operator: a preliminary report. Surg Laparosc Endosc Percutan Tech 23(2):176–179PubMedCrossRef
8.
Park JM, Suh SW, Kwak JM, Kim J, Kim SH (2011) Three-port laparoscopy-assisted colectomy for colorectal cancer using external traction with suspension suture. Surg Laparosc Endosc Percutan Tech 21(5):e249–e252PubMedCrossRef
9.
Bresadola F, Pasqualucci A, Donini A, Chiarandini P, Anania G, Terrosu G, Sistu MA, Pasetto A (1999) Elective transumbilical compared with standard laparoscopic cholecystectomy. Eur J Surg 165(1):29–34PubMedCrossRef
10.
Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A 9(4):361–364PubMedCrossRef
11.
12.
Kaouk JH, Haber GP, Goel RK, Desai MM, Aron M, Rackley RR, Moore C, Gill IS (2008) Single-port laparoscopic surgery in urology: initial experience. Urology 71(1):3–6PubMedCrossRef
13.
Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Color Dis 10(8):823–826CrossRef
14.
Choi SI, Lee KY, Park SJ, Lee SH (2010) Single port laparoscopic right hemicolectomy with D3 dissection for advanced colon cancer. World J Gastroenterol 16(2):275–278PubMedPubMedCentralCrossRef
15.
Poon JT, Cheung CW, Fan JK, Lo OS, Law WL (2012) Single-incision versus conventional laparoscopic colectomy for colonic neoplasm: a randomized, controlled trial. Surg Endosc 26(10):2729–2734PubMedCrossRef
16.
Lim SW, Kim HJ, Kim CH, Huh JW, Kim YJ, Kim HR (2013) Umbilical incision laparoscopic colectomy with one additional port for colorectal cancer. Tech Coloproctol 17(2):193–199PubMedCrossRef
17.
Choi EK, Yoo IR, Park HL, Choi HS, Han EJ, Kim SH, Chung SK, Joo Hyun O (2012) Value of surveillance (18)F-FDG PET/CT in colorectal cancer: comparison with conventional imaging studies. Nucl Med Mol Imaging 46(3):189–195PubMedPubMedCentralCrossRef
18.
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213PubMedPubMedCentralCrossRef
19.
Kim SJ, Choi BJ, Lee SC (2014) Overview of single-port laparoscopic surgery for colorectal cancers: past, present, and the future. World J Gastroenterol 20(4):997–1004PubMedPubMedCentralCrossRef
20.
Ishii Y, Hasegawa H, Endo T, Ochiai H, Okabayashi K, Kitagawa Y (2013) Reduced-port laparoscopic surgery for rectal cancer: feasibility based on our early experience. Asian J Endosc Surg 6(3):249–252PubMedCrossRef
21.
Hirano Y, Hattori M, Douden K, Shimizu S, Sato Y, Maeda K, Hashizume Y (2012) Single-incision plus one port laparoscopic anterior resection for rectal cancer as a reduced port surgery. Scand J Surg 101(4):283–286PubMedCrossRef
22.
Costedio MM, Aytac E, Gorgun E, Kiran RP, Remzi FH (2012) Reduced port versus conventional laparoscopic total proctocolectomy and ileal J pouch-anal anastomosis. Surg Endosc 26(12):3495–3499PubMedCrossRef
23.
Champagne BJ, Lee EC, Leblanc F, Stein SL, Delaney CP (2011) Single-incision vs straight laparoscopic segmental colectomy: a case-controlled study. Dis Colon Rectum 54(2):183–186PubMedCrossRef
24.
Kurmann A, Vorburger SA, Candinas D, Beldi G (2011) Operation time and body mass index are significant risk factors for surgical site infection in laparoscopic sigmoid resection: a multicenter study. Surg Endosc 25(11):3531–3534PubMedCrossRef
25.
Hübner M, Diana M, Zanetti G, Eisenring MC, Demartines N, Troillet N (2011) Surgical site infections in colon surgery: the patient, the procedure, the hospital, and the surgeon. Arch Surg 146(11):1240–1245PubMedCrossRef
26.
Kim SJ, Ryu GO, Choi BJ, Kim JG, Lee KJ, Lee SC, Oh ST (2011) The short-term outcomes of conventional and single-port laparoscopic surgery for colorectal cancer. Ann Surg 254(6):933–940PubMedCrossRef
27.
Hasegawa H, Kabeshima Y, Watanabe M, Yamamoto S, Kitajima M (2003) Randomized controlled trial of laparoscopic versus open colectomy for advanced colorectal cancer. Surg Endosc 17(4):636–640PubMedCrossRef
28.
Lim SB, Choi HS, Jeong SY, Park JG (2008) Feasibility of laparoscopic techniques as the surgical approach of choice for primary colorectal cancer: an analysis of 570 consecutive cases. Surg Endosc 22(12):2588–2595PubMedCrossRef
29.
Braga M, Vignali A, Gianotti L, Zuliani W, Radaelli G, Gruarin P, Dellabona P, Di Carlo V (2002) Laparoscopic versus open colorectal surgery: a randomized trial on short-term outcome. Ann Surg 236(6):759–766, discussion 767 PubMedPubMedCentralCrossRef
30.
Le Voyer TE, Sigurdson ER, Hanlon AL, Mayer RJ, Macdonald JS, Catalano PJ, Haller DG (2003) Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089. J Clin Oncol 21(15):2912–2919PubMedCrossRef
31.
Park SJ, Lee KY, Kang BM, Choi SI, Lee SH (2013) Initial experience of single-port laparoscopic surgery for sigmoid colon cancer. World J Surg 37(3):652–656PubMedCrossRef
32.
Rosati CM, Boni L, Dionigi G, Cassinotti E, Giavarini L, David G, Rausei S, Rovera F, Dionigi R (2013) Single port versus standard laparoscopic right colectomies: results of a case-control retrospective study on one hundred patients. Int J Surg 11(Suppl 1):S50–S53PubMedCrossRef
Metadata
Title
Short-term outcomes following reduced-port, single-port, and multi-port laparoscopic surgery for colon cancer: tailored laparoscopic approaches based on tumor size and nodal status
Authors
Hyeon Yu
Jin Yong Shin
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 1/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-015-2399-z

Other articles of this Issue 1/2016

International Journal of Colorectal Disease 1/2016 Go to the issue

Original Article

Stapled hemorrhoidopexy: functional results, recurrence rate, and prognostic factors in a single center analysis

Original Article

Is there a role for prophylactic colectomy in Lynch syndrome patients with inflammatory bowel disease?

Original Article

Layer-oriented total pelvic exenteration for locally advanced primary colorectal cancer

Letter to the Editor

Adequacy of lymph node yield and staging in rectal cancer should not be determined based on a minimum number of lymph nodes evaluated

Original Article

Laparoscopic surgery of benign entero-vesical or entero-vaginal fistulae

Original Article

Practical problems of measuring depth of submucosal invasion in T1 colorectal carcinomas